Thursday, April 22, 2010

Circumcision: Already Illegal?

I often come across parents who do not agree that circumcision should be illegal. They usually argue by saying it is a parental decision like vaccination, homebirth, etc. Here is my response:

Vaccines cannot be compared to a cosmetic surgery that removes healthy organs for non-therapeutic purposes. This is like comparing apples to oranges. Let's stick with comparing other actions that are considered bodily modifications of non-consenting minors when contemplating the legality of circumcision.

Piercing is a body modification, but because it does not alter the function of a body part, nor does it remove any tissue or organs, it is generally accepted within reason (earlobes, for example).

Tattooing is much more extreme in that it is permanent, yet it still does not remove any organ or alter the functions of any healthy body parts. However, most people agree that parents should not be able to tattoo their infants or children. In fact, a Florida family was recently charged with cruelty to children for tattooing their 6 kids.

And then you have circumcision - a genital surgery which does alter the function of the primary sex organ, does remove otherwise healthy tissue and the prepuce organ, does alter appearance forever more and is permanent. If you aren't allowed to tattoo your children, why on earth would you be legally able to remove healthy, functioning tissue from your son's genitals?

Besides being creepy that a parent would have the say over the cutting of their child's genitals, circumcision of children violates all our current laws concerning alterations of a child's body. In our country we have laws in place that are designed to protect the bodies of children. These laws state that no parent can request to alter their child's body unless: A) it is medically indicated and B) a more conservative treatment has failed to correct the medical problem that exists. These laws are in place because bodily integrity (an intact body) is considered a basic human right in our society.

Human rights are granted to every single person regardless of gender, age, nationality, culture or religion. Furthermore, doctors caring for patients who are under the age of 18 are not legally permitted to perform any surgery on a minor unless there is clear medical need and more conservative treatment has failed . This is basic medical ethics, and yet somehow circumcision has become the exception to this well established legality. A parent cannot ask a doctor to remove a fingernail, an earlobe, a toe, or any other part of the body. A parent cannot remove the clitoral hood of their daughter (which is the female foreskin - the prepuce). A parent cannot even pin prick their daughter's genitals without it being a federal crime punishable under the FGM Bill. Basically, every square inch of a child's body is protected by bodily integrity laws and medical ethics laws -- every square inch, that is, aside from the infant male foreskin. How can this be?

Now one can try to argue that circumcision is in some way a form of preventative medicine, however, in doing so, we will run into trouble arguing this because we are no longer living in a day and age where amputation is considered preventative medicine. In modern medicine, amputation is always a LAST resort when conservative methods have failed. The only reasons amputation would be considered a first choice would be in the case of gangrene, malignancy, frostbite, or serious trauma to that body organ.

In addition, when you amputate any part of the body you remove the off-chance that something can go wrong with that part. After all, it no longer exists! That isn't rocket science. The male foreskin, however, is no more pathological than any other part of the body. In fact, the intact female genitals are more likely to cause its owner problems than any intact man will ever experience on behalf of his foreskin. 65% of American women will have a bacterial vaginal infection in their lifetime, 40% of women will have yeast infection in their lifetime, and girls are six times more likely to suffer from a urinary tract infection (easily treated with antibiotics). Each of these health concerns for girls and women far out number any problems a boy or man may have with his foreskin at any point in life, yet somehow we find a way to treat women without amputating genital organs. In the unlikely event that a man has a foreskin problem, he can enjoy the same conservative methods of treatment that are allotted to women. Studies conducted in countries that do not routinely circumcise have found that less than 1 in 6,000 men will ever need circumcision surgery for medical reasons.

We must attend to the fact that no medical organization in the entire world recommends routine infant circumcision. Each and every organization has made a statement that the potential benefits do not outweigh the risks and guaranteed negative consequences. This alone is proof to the absurdness of using circumcision as preventative medicine.

The final, last ditch effort to arguing for circumcision would be the very controversial study that was performed in Africa. Even if you believe this study, which is loaded with methodological errors, you'd only have a reduction in female-to-male sexual transmission of HIV. In our country 88% of HIV is transmitted through male-to-male intercourse and/or IV drug use. Circumcision has proven no benefit for male-to-female transmission, male-to-male transmission, or IV drug use.

In reviewing The Nuts and Bolts of HIV in the USA and Why Circumcision Won't Protect Men you will see that a heterosexual American man who engages in moderately risky sexual activity will have a less than .03% chance of catching HIV over a 60 year period...not exactly a reason to routinely circumcise all infant boys. Aside from this statistic, we can all agree that infants and young boys don't engage in sexual activity until they reach an age where they can make an informed decision as to whether or not they want to amputate their precious foreskins.

All this, and I still haven't even mentioned that a 5-year review of this so-called 'study' in Uganda reported that the circumcised group and their female partners began to acquire HIV at alarmingly higher rates. Rates so high, in fact, that the study ended early due to ethical concerns. These results (circumcision increasing HIV transmission in Africa) were not formally published because the study ended early. There are several studies in the last decade that have reported no reduction in sexually transmitted infections or HIV among circumcised males. Several studies report higher rates among circumcised men. Our nation's track record should be testimony to an already failed circumcision experiment. We are, after all, the only developed nation in the world who routinely circumcises boys and we also happen to have thee highest STD and HIV rates of any other developed nation.

Last but certainly not least, there was a recent study of circumcised females which reported a 50% reduction in HIV among circumcised women. Shall we also suggest that women be circumcised based on the findings of this study? This is all moot point, however, because we do have effective protective methods against HIV and all sexually transmitted infections: condoms. Condoms are over 98% effective and do not involve any genital reduction surgery on non-consenting persons.

So there you have it.

Circumcision violates our human rights laws, which are designed to protect the bodies of minor children.

Circumcision violates our medical ethics laws that state a doctor can only perform procedures on a minor when there is clear medical need and a more conservative treatment has failed.

Circumcision is not good preventative medicine because amputation is always a last resort to conservative treatments.

Circumcision on babies cannot be considered a good prophylactic measure against sexually transmitted infections.

And last but not least, because baby girls are protected from even the most minor genital surgery (even a pin prick), circumcision is a violation of the equal protection clause of the Constitution of the United States which states that, "all persons shall receive equal protection under the law" regardless of sex.

Case closed, circumcision is technically already illegal. The question is not then whether or not it is legal to circumcise a child - we have already established that the male foreskin and its removal exists outside our legal and medical norms. The real question is, when will our government recognize that they have failed to apply the law accordingly and, in doing so, they have failed to protect our most innocent and most fragile of citizens?

25 comments:

Isn't it funny how the results from the study that showed a greater risk to women were not published due to the study ending early, yet that didn't stop them with the ones that showed a reduction in HIV w/ male circumcision. (and were also ended early)

Claire: Babies don't have sex. Babies don't get HIV through sexual activity, nor do women get HIV from babies. We're talking about babies and children too young to make this decision or have their cries of pain and protest heeded. If boys want to be circumcised when they're old enough to express that desire, they ought to absolutely have that choice. Likewise, if women only wish to be sexually active with circumcised men, that is also their choice. But that is THEIR CHOICE to make, not yours.

Now, given that there does seem to be a reduction in HIV associated with circumcision, what advice would you have for sexually active people? I mean, would you advise that they can forgo condoms simply because their partner is circumcised? The answer to that ought to clearly be "no."

I grow ever more suspicious that the African clinical trials are a festering boil that will turn into an intellectual scandal. They simply don't smell right. The trial were rigged to yield the desired outcome, that circ is a silver bullet against AIDS.

Wiswell's 1986 study that intact boys are 11 times more likely to contract a UTI in infancy than circed boys also needs to be redone from scratch. Wiswell claims to have sifted through the records of about 400,000 baby boys born in US military hospitals over a 10 year period. In 1986, the computer technology for doing a task of that magnitude simply did not exist.

Thank you for explaining the Africa AIDS study. I always hear about it, pro and con, but no one ever can tell me what it says, just that it either a) prevents AIDS transmission or that b) it's flawed. I appreciate the breakdown.

I am against it because it is not his religion, it is his parents. According to the UN charter of children's rights, freedom to choose religion is a right for children. Parents may instruct them, but it cannot be forced on anyone.At 18 if he is jewish and believes circumcision is part of his religion (many do not, jewsagainstcircumcision.com exists for a reason!)he may choose to do it.

Ask yourself this: If part of the religion is to make a sacrifice to a deity, yet the sacrifice comes not from choice, but by being forced on someone who doesn't even have the capacity to understand what a sacrifice is, does it really count? Is it really any better than someone saying they are subjecting their son to cosmetic surgery because they personally find it aesthetically pleasing?

-I am jewish, I love intact men, and of those that decide circumcision is right for them, their faith, and their lives, I respect them to make that choice for themselves, but refuse to allow them to do such to infants.-

I have an idea. Let's ALL forward this article to our congressmen an local federal district judges, asking them to review the issue on grounds of unconstitutionality. Looking up my congressmen's official emails now...

I love this post. I used to be pro-circ and ignore all this information . . . but then I finally read it (and tried to watch a video, I only got 30 seconds in) and am proud to be staunchly against circumcision. I am also working on letters to my congresspeople.

However, I am an APP affiliated piercer, and I feel the need to spread the proper information about what is seen as "harmless" by society.

My ears were pierced via piercing gun at 6 months. They migrated completely out by age 12 and I had to have surgery before I could re-pierce them at age 15.

The earlobe does not stop growing until around age 12. Piercing before that age can lead to migration of the piercing (even the extreme of migrating completely out of the earlobe and requiring surgery to close). Also, a trained piercer will use a sterile needle and clamp along with proper jewelry . . . ear piercing guns were invented to TAG WILDLIFE and they cannot be adequately sterilized. The traditional posts used traumatize the tissue because they are too blunt, and the backs are a great bacteria trap. The cleaning solution mall stores give you actually strips away good bacteria that promote healing; sea salt and warm water is all you need for care. Lastly, earlobe piercings often never completely close up, making them a permanent modification. Because of the vascular nature of the tissue, they heal quickly but rarely fully close.

I do love that this page advocates genital autonomy for children, but what about BODY autonomy?

I agree with you. I didn't know it was dangerous before 12 years of age.I had my ears pierced when I was 4, and it was my choice and I was happy. My sister might get her's done soon (she is now 4).

My ears were constantly infected (mostly just my right one) and needed re-pierced several times. It still hurts if I wear earrings but only for about 2 days after, once the puss and imflamation go down it's fine, and it only takes a few minutes to trigger that, and taking them out is highly painful.I guess I will do like I did for her twin and pass on information that is needed so hopefully they stay safe (he is the youngest of 3 boys, the older 2 were cut. The oldest one wasn't going to be but the doctor said to retract, it was bad, so the other one got it done too, and then I found intactivist information and the youngest one is safe)

Amelia - I am with you on the ear piercing. I chose to have my ears pierced at age 10-11. They aren't closed up, and they get infected every time I wear any type of sub-standard earring. I am OK with this because it was my choice to have it done. I would have been more upset if my parents had pierced my ears when I was a baby. I try to be polite, but I am absolutely against parents piercing any body part on a baby or young child.

As a heavily pierced and tattooed person, and a mother, I completely agree with you. A reputable piercer will not pierce a baby or young child. My old piercer had a sign in the window "We do not enjoy making babies and young children cry; please do not bring them in to be pierced!"

Once the child is old enough to make that decision themselves (and that varies from child to child) I strongly advocate taking them to a proper piercing studio as opposed to say, Claire's or a hairdressing salon, to have their ear piercings done properly with needles. Gun piercings are usafe, unsanitary and do untold tissue damage, which is probably why yours are in such bad condition.

"In our country we have laws in place that are designed to protect the bodies of children. These laws state that no parent can request to alter their child's body unless: A) it is medically indicated and B) a more conservative treatment has failed to correct the medical problem that exists. These laws are in place because bodily integrity (an intact body) is considered a basic human right in our society."

Thank you for writing this blog. I'm a regular reader of JAMA (the reference publication for 99% of the medical professionals in the world) and there's tons of circumcision studies. There are a lot of studies that test the theory of circumcision and its benefits BUT there is not ONE article that states, claims, or concludes that there is any medical benefits of circumcision or negative consequences of being uncircumcised.

Circumcision originated from ancient times within religion to show conviction to god and to separate a man from the savage or beast. That worked then but now people are "smarter" so they use medical benefits as the guiding principal behind circumcision.

It's not simply a snip. Google "male circumcision procedure". At birth and till the first year, the head of the penis and the foreskin are "one". Only until the age of 7 or 8 does the head actually completely separates from the foreskin. When an infant is prepped for circumcision surgery, they are bound to a plastic teflon board. A bladed tube is shoved down between the head of the penis and the foreskin. This cuts or tears the head from the foreskin. Once this happens a blade is used to cut around the foreskin and then finally removed. While I'm against circumcision, for crying out loud, at least wait till the head and foreskin are separated. It's a brutal brutal brutal procedure.

I am circumcised but my son is NOT. After reading all of the pros of circumcision, I came to realize it was all religious and medical rhetoric. Religious reasons... I can't win the argument because it's simply religion. But from the medical end, it's all to front the average $200 procedure in the US. It's money folks!!!! If hospitals couldn't charge a dime for circumcision... the circumcision rate would be 0%.

There are articles in JAMA that state and claim that having breasts can cause breast cancer. You've seen all of these 5K charity walks for breast cancer. Are they going to remove breasts in the future? Of course not!!!

The Equal Protection Clause (8.6) of the 14th Amendment of the U.S. Constitution prohibits U.S. States from denying any person within their jurisdiction equal protection of the laws.

Section 1 of this clause reads:

"All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws."

The Universal Declaration of Human Rights, adopted in December, 1948, by members of the United Nations declares in Articles 2 and 5:

"Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. Furthermore, no distinction shall be made on the basis of the political, jurisdictional or international status of the country or territory to which a person belongs, whether it be independent, trust, non-self-governing or under any other limitation of sovereignty.

No one shall be subjected to torture or to cruel, inhuman, or degrading treatment or punishment."

The Federal Prohibition of Female Genital Mutilation Act of 1995 (which was signed into law in 1996, and went into effect - punishable as a felony under federal U.S. law in 1997) prohibits ANY genital cutting of any kind - including small pin pricks or nicks - to a minor child or baby under the age of 18, for any reason whatsoever (religious or otherwise).

This FGM Bill, in combination with the 14th Amendment Clause 8.6, makes all forms of MGM equally a federal violation.

I agree with everything, but there is a form of body-modification that people do that is similar to piercing, but instead they use a punch! Makes large gauge holes much easier than piercing then stretching.

Love your website. If it wasn't for you, we probably would have circ-ed.